Avulsion fracture of the tibial tubercle in a child with testicular feminization syndrome

Apophyseal avulsion fracture of the tibial tuberosity is rare. It often affects athletic adolescent males approaching skeletal maturity. This injury has been reported in children with existing or previously treated Osgood-Schlatter's disease (OSD) and osteogenesis imperfecta. We present an adolescent boy with an avulsion fracture of the tibial tubercle with testicular feminization syndrome (TFS) and have been previously treated for OSD. We report a late presentation of a rare tibial tuberosity fracture with intra-articular extension in a 15-year-old athletic boy with TFS and a previous history of OSD. He was managed by open reduction and internal fixation under image guidance. Young general practitioners should have a high index of suspicion when children present with knee pain and swelling following sporting activities in order not to miss such an injury.